Inter- and intra-observer agreement on Miller’s classification of gingival tissue recessions

Bertl, Kristina; Ruckenbauer, Dorothea; Müller-Kern, Michael; Durstberger, Gerlinde; Lettner, Stefan; Bruckmann, Corinna; Ulm, Christian

doi:10.1007/s10266-014-0179-9

Cited by 6 publications

(6 citation statements)

References 24 publications

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“…Our data is also in agreement with the findings of Bertl et al 17 in 2015 on the inter- and intra-observer agreement for several parameters, revealing substantial to almost perfect intra-observer agreement in the use of Miller’s classification, (in our study, level of inter-observer agreement was almost perfect). In the study by Bertl et al gingival phenotype and tooth shape were evaluated.…”

Section: Discussionsupporting

confidence: 93%

Inter- and intra-examiner agreement of three classification systems of gingival recession

Sarlati

Moghaddas

Shabahangfar

et al. 2019

J Adv Periodontol Implant Dent

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Background. Several classifications have been proposed for gingival recession defects. Correct diagnosis of the type of gingival recession is necessary for proper treatment planning and assessment of the prognosis. Considering the existing uncertainty regarding the reliability of different classification systems available for gingival recession and their shortcomings, this study sought to assess the reproducibility and reliability of accuracy of three available classifications (Cairo, Mahajan and Miller’s classification systems) for gingival recession. Methods. This descriptive study was conducted on 32 patients presenting to the Department of Periodontics, who were selected using convenience sampling. The screening process entailed two sessions and those with a minimum of one site of gingival recession disclosing the cementoenamel junction (CEJ) of the tooth with no adjacent tooth loss at the site of recession were enrolled. Each patient was separately evaluated by three calibrated examiners twice with a minimum of one-week interval. Grading of the gingival recession defects was determined using the Cairo, Mahajan and Miller’s classification systems for gingival recession. The gradings of each examiner were separately recorded by a blinded examiner. A total of 120 single recession defects were examined and data were analyzed using intra-class correlation coefficient (ICC) and Spearman’s test. Level of agreement was evaluated according to Landis and Koch. Results. The results showed that the reliability of all the three methods was almost perfect (P<0.05), and no significant difference was noted in reliability of the Cairo, Mahajan and Miller’s classifications for gingival recession (P=0.7). Conclusion. Based on the results of the study, the highest intra- and inter-observer agreement in the use of the three classifications belonged to the Cairo classification; however, all the three classifications showed high reliability

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Section: Discussionsupporting

confidence: 93%

Inter- and intra-examiner agreement of three classification systems of gingival recession

Sarlati

Moghaddas

Shabahangfar

et al. 2019

J Adv Periodontol Implant Dent

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“…It has a multifactorial etiology that is directly attributed to anatomical, mechanical, and pathological factors, that is, the quantity and quality of the gingival tissues, traumatic brushing habits, and plaque accumulation that causes an inflammatory process 19 . It is predominant in males and affects the vestibular aspect of the teeth 21 . The present case report shows Miller class I recessions, which are characterized by no extension of the gingival margin to the mucogingival line without interdental bone loss 18‐20,22 .…”

Section: Discussionmentioning

confidence: 61%

Subepithelial connective tissue graft conjugated to minimally invasive ceramic laminates—1 year follow‐up

Costa

Zica

Júnior

et al. 2020

J Esthet Restor Dent

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Objective: Commonly, esthetic procedures involve ceramic laminates and gingivectomy. However, the clinical demand caused by dental wear and gingival recessions due to parafunctional habits is increasing. Thus, in addition to restoring the anatomical and esthetic dental form, it is also necessary to restore the lost gingival volume. Clinical considerations: This article presents a case report of the treatment of a patient with marked incisal wear and gingival recessions. Initially, endodontic treatment of the upper lateral incisors was performed, which presented with pulp necrosis due to the marked wear caused by bruxism. Subsequently, the patient was treated with a subepithelial connective graft by a technique proposed by Zucchelli, along with minimally invasive ceramic laminates and finished with a myorelaxant plaque. Conclusions: This proposed approach aimed for and achieved esthetic excellence, and full recovery of function, which is of extreme clinical relevance. Ultimately, the stability of the surgery and the laminates after 1 year of follow-up is presented.Clinical Significance: Patients with bruxism in addition to incisal and occlusal wear are more likely to have gingival recessions. The esthetic planning of these patients should contemplate interdisplinarity temporomandibular disorder, periodontics, and dentistry for the recovery of the function and reaching esthetic excellence. K E Y W O R D Sconnective tissue, dental laminates, gingival recession

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“…The difference in these results could be due to differences in the method of gingival recession assessment. Bert et al assessed gingival recession defects using photographs, whereas we assessed them using the patients [32].…”

Section: Discussionmentioning

confidence: 99%

“…However, our results are in accordance with those of Mahajan et al, who also demonstrated less reliable agreement using Miller's classification (κ = 0.57-0.68) and inter-rater observations (κ = 0.66). This could be due to the fact that Mahajan also assessed recession defects on the patients and not through assessment using photographs, as done byBert et al [32].…”

Section: Discussionmentioning

confidence: 99%

Assessing the Reliability of Miller’s Classification and Cairo’s Classification in Classifying Gingival Recession Defects: A Comparison Study

Fageeh,

Bhati

et al. 2024

Medicina

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Background and Objectives: Gingival recession results in adverse aesthetics and root sensitivity, and there is a need to treat and prevent its further progression. To overcome these problems, various advances have been made by clinicians in treating gingival recession based on the type of gingival recession. Miller’s classification has been used for a long time to classify the type of recession. However, certain limitations have been found with use of Miller’s classification such as a lack of clarity in the method for measuring soft and hard tissue loss in the interproximal area. Cairo classification was proposed to overcome limitations of Miller’s classification to classify gingival recession. Cairo’s classification is a treatment-oriented classification based on buccal and interproximal attachment loss. Therefore, the study was conducted to assess and compare the reliability of Miller’s and Cairo’s classifications in determining gingival recession. Material and methods: A total of 220 buccal gingival recession defects were included in the study based on the inclusion and exclusion criteria. Four examiners were included in the study. Two examiners classified the recession defects according to Miller’s classification and the other two examiners classified recession defects according to Cairo’s classification at baseline and at a 1-week interval. Statistical analysis was conducted using SPSS software version 25.0 using Cohen’s kappa correlation coefficient and Chi-square test statistics to determine the intra- and inter-rater agreement among the examiners for the two gingival recession classification systems. A p value of <0.05 was considered statistically significant. Results: The intra-rater agreement for Cairo’s classification was 0.86 and 0.82, whereas for Miller’s classification, it was found to be 0.68. The inter-rater reliability agreement for Cairo’s classification was 0.82 and 0.8, whereas for the Miller’s classification, it was 0.56 and 0.67. Conclusions: Within the limitations of the study, it was found that Cairo’s classification is clearer and more reliable than Miller’s classification in the assessment of gingival recession.

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Inter- and intra-observer agreement on Miller’s classification of gingival tissue recessions

Cited by 6 publications

References 24 publications

Inter- and intra-examiner agreement of three classification systems of gingival recession

Inter- and intra-examiner agreement of three classification systems of gingival recession

Subepithelial connective tissue graft conjugated to minimally invasive ceramic laminates—1 year follow‐up

Assessing the Reliability of Miller’s Classification and Cairo’s Classification in Classifying Gingival Recession Defects: A Comparison Study

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